| Doctor Name: | BETH BORNE' KENNEDY |
| NPI Number: | 1649417783 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 1879C |
| Business Practice Address: | 7345 Highway 62 W Gassville, AR - 726358636 |
| Business Phone Number: | 8704355511 |
| Business Fax Number: | 8704355513 |
| Mailing Address: | 624 Hospital Dr, MOUNTAIN HOME |
| State: | AR |
| Postal Code: | 726532955 |
| Phone Number: | 8704355511 |
| Fax Number: | 8704355513 |
| NPI Enumeration Date: | 01/12/2009 |
| NPI Last Update Date: | 03/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1879C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |